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- The small intestines (bowels) are the primary digestive system where nutrients are absorbed. The small intestines include the duodenum, jejunum, and ileum. The small intestines connect from the stomach above to the colon below. A Small Bowel Obstruction occurs when small intestines become obstructed (i.e., they are no longer allowing food and liquids to pass).
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- Cramping abdominal pain that comes in waves initially, then becomes constant
- Abdomen distends
- Vomiting
- Constipation
- Inability to pass gas
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- Adhesions (surgical scars on the outside of the bowels, usually from previous surgeries)
- Hernias -- internal and external
- Volvulus (the small intestine slides over itself)
- Crohn's Disease
- Cancer
- Radiation enteritis (inflammation/scarring from radiation treatment for cancer)
- Intestinal wall hematoma
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- Mild abdominal tenderness
- High pitched bowels sounds-"tinkles" and "rushes"
- Careful check for hernias should be performed
- Initially normal
- As the person becomes more ill, electrolyte imbalances, increased white blood cell count and hemoconcentration may occur
- Dilated loops of bowel to measure the air-fluid levels. Complete obstruction of the colon and rectum may leave little or no room for air. In strangulation, thickening and thumb printing of the small bowel may occur.
- Barium Enema may confirm the diagnosis if there is a question
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- Nasogastric decompression
- Intravenous fluids
- Broad-spectrum antibiotics if strangulation is suspected
- Surgical consultation is often needed. Surgery is usually performed for complete bowel obstructions.
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- Bowel strangulation-blood supply to the small intestine is cut off, bringing about the possibility that the small bowel may die, leading to infection, Shock, or even death. Also perforation (a hole in the bowel) or peritonitis (infection of the bowel cavity may occur).
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- This is a medical emergency that requires immediate emergency treatment!
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